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Irritable bowel syndrome: What you should know about the condition
For those diagnosed with colon cancer, treatment has come a long way. Options include surgery, chemotherapy, radiotherapy, targeted drugs, and immunotherapy.
When most of us think about stomach upsets, constipation, or sudden trips to the toilet, our first suspicion isn’t cancer. We are more likely to blame it on stress, diet, or irritable bowel syndrome (IBS), a common digestive disorder.
Dr Stephen Kairu, a consultant physician and gastroenterologist, says this is the reality for thousands of patients he sees with IBS. It is one of the most common digestive disorders worldwide, affecting about 10 to 15 percent of the population.
“We see it in young people, professionals in their40s, even the elderly,” he says. “It is not a disease of age; it cuts across.”
Patients describe constant abdominal pain that comes and goes without warning. Others talk about feeling bloated and pressure from gas, even after eating little food.
“For some, the problem is constipation; they can go a day or two, sometimes longer, without bowel movement. For others, it’s the opposite: frequent loose stools, sometimes with mucus. And then some feel an endless urge to go, yet only manage to pass tiny amounts of stool.”
Patients complain of poor sleep, constant fatigue, nagging headaches, and even widespread muscle pains. Productivity dips, concentration vanishes, and stress creeps in. “By this point, the quality of life is really poor,” Dr Kairu explains. “People miss work, they’re anxious all the time, and it becomes a cycle.”
So why does the gut behave this way? “Scientists believe the answer lies in the gut-brain connection. Our digestive system is in constant conversation with our brain, and normally, the rhythm flows smoothly. Stress can make the gut act up, and gut problems can, in turn, worsen anxiety. This is why probiotics, those live microorganisms we take in supplements or certain foods, are sometimes recommended. They help restore that balance, crowding out the bad bacteria and supporting digestion.”
However, IBS does not show up on any lab test. There is no blood test, stool test or scan that can confirm it. Diagnosis is made purely through listening to the patient’s story. Yet most people with tummy issues are immediately tested for H. Pylori.
When that test comes back positive, as it often does, they are put on antibiotics. “The problem is, IBS isn’t caused by H. Pylori,” he clarifies. “I meet patients who have taken the kits four, even five times. They keep wondering why they never get better.”
Vomiting blood, blood in stool, unexplained weight loss, anaemia, or fever are red flags that may suggest something more serious. In such cases, further tests are essential to rule out things like colon cancer.
Dr Kairu says the first step to managing IBS is simply getting the diagnosis right. “Medication comes next. Treatment depends on the patient’s particular problem, such as constipation, diarrhoea, or a mix. Severe cases may need a more careful combination.” Can a change of diet help ease IBS?
“The low-FODMAP approach is one of the most effective tools. It cuts out foods that contain certain hard-to-digest carbohydrates, which ferment in the gut and cause gas and bloating,” he says. That means avoiding, at least temporarily, apples, pears, mangoes, watermelon, onions, garlic, cauliflower, kale, dairy products like milk, wheat, barley, and even sweeteners like honey and high-fructose corn syrup. Over time, these foods are reintroduced one by one to pinpoint which ones are real troublemakers.”
Dr Omar Abdihamid, a clinical oncologist and cancer researcher at Shabaha Cancer Centre, explains that confusing IBS and colon cancer two is quite common and can sometimes delay life-saving treatment. The two are often lumped together in everyday conversations because their symptoms overlap.
He clarifies that colon cancer is essentially the uncontrolled growth of abnormal cells in the large intestine. On the other hand, IBS is a functional gut disorder that causes abdominal pain, bloating, diarrhoea, or constipation, but it does not increase the risk of colon cancer. “They are completely separate conditions,” he says.
So, who is most at risk of developing colon cancer?
“The odds go up as we grow older, particularly past 50 years. A family history of the disease, certain genetic syndromes, and lifestyles that involve heavy consumption of red or processed meat, smoking, obesity, and inactivity all add to the risk.”
Dr Omar points out that while only about 5 to 10 percent of cases are linked to inherited genes, the overwhelming majority are tied to lifestyle choices.
Interestingly, diet and inactivity don’t just influence colon cancer; they can also worsen IBS symptoms. “This is where people get it wrong,” Dr Omar explains. “IBS doesn’t cause colon cancer, but the same poor lifestyle habits can aggravate both.”
One of the biggest challenges with colon cancer is that its early symptoms can mimic IBS. Blood in the stool, persistent changes in bowel habits, unexplained fatigue, or sudden weight loss should never be ignored.
“If any of these symptoms persist for more than four weeks, or if there’s rectal bleeding, you need to be tested,” Dr Omar advises. Sadly, many people dismiss rectal bleeding as piles (haemorrhoids) or attribute anaemia to diet, not realising these could be red flags. This delay often means the cancer is discovered late.
The good news? A colonoscopy, a medical procedure performed using a colonoscope, which involves checking for bowel abnormalities and diseases in the colon and rectum, is highly reliable and, contrary to popular belief, not as uncomfortable as people think. Screening is generally recommended from age 45 to 50, or earlier if there is a strong family history.
Can IBS be mistaken for cancer? “Yes, but rarely, provided the right tests are done,” says Dr Omar. Colonoscopy, combined with biopsy, remains the gold standard in telling the two apart. While IBS is a functional disorder with no visible structural damage, cancer shows up as tumours or abnormal growths that can be biopsied.
For those diagnosed with colon cancer, treatment has come a long way. Options include surgery, chemotherapy, radiotherapy, targeted drugs, and immunotherapy. “Treatments are now more precise and less toxic than they were a decade ago,” Dr Omar notes.
However, they can still affect bowel habits, sometimes permanently. That’s why supportive care, nutrition counselling, exercise, and stress management often play an important role in improving quality of life during and after treatment.
The silver lining is that colon cancer is one of the most preventable cancers.
Simple lifestyle changes like eating more fruits, vegetables, and whole grains, exercising regularly, quitting smoking, and moderating alcohol make a significant difference. For those with a family history, prevention goes a step further: start screening early, maintain a healthy lifestyle, and consider genetic counselling.
Perhaps the most dangerous myths around colon cancer are that it only affects older people, that it’s always fatal, or that screening is unbearably painful. “In Kenya, many younger adults think they are too young to worry about it, which is not true. We are increasingly seeing cases among people under 45,” he adds.
